Research project Benefits, tensions and inconsistencies in the health and welfare system
The case of New Public Management in Swedish substance abuse treatment
The study analyses the extent to which tendencies of NPM have conveyed advantages or created conflicting logics by comparing health and social care based SAT in 2-3 regions/county councils and 6 municipalities with varying degrees of NPM. The study uses documents and interviews (N≈90) are made with state, regional and local policy-makers and bureaucrats, including purchasers of care, and with private and public care providers (owners, managers, street-level professionals). Interviews form the basis for a web-survey among professionals in Sweden.
Project description
Welfare systems have gone through major changes regarding modes of operation and means of control in New Public Management (NPM) reforms seeking to balance autonomy and control. The study uses substance abuse treatment (SAT), with different organizations and professions, as a case for studying the impact of NPM on the daily work in health and social services. There is a lively debate about NPM but research is scarce. It indicates improved performances but also unintended consequences and inconsistencies concerning ideas, demands on the services and performance incentives, e.g. tensions between medical and social professional autonomy and knowledge on the one hand and administrative control, auditing and a growing bureaucracy (procurement, inspections, etc.) on the other.
The study analyses the extent to which tendencies of NPM have conveyed advantages or created conflicting logics by comparing health and social care based SAT in 2-3 regions/county councils and 6 municipalities with varying degrees of NPM. The study uses documents and interviews (N≈90) are made with state, regional and local policy-makers and bureaucrats, including purchasers of care, and with private and public care providers (owners, managers, street-level professionals). Interviews form the basis for a web-survey among professionals in Sweden.
Project members
Project managers
Jessica Storbjörk
Associate professor
Members
Erik Antonsson
Reserach assistant
Filip Roumeliotis
vik. lektor
Eva Samuelsson
Senior lecturer, associate professor
Kerstin Stenius
Professor Emerita
More about this project
Documentation
Stenius, K., Storbjörk, J. (2020). Balancing welfare and market logics: Procurement regulations for social and health services in four Nordic welfare states. Nordic Studies on Alcohol and Drugs, 37(1), 6-31.
https://doi.org/10.1177/1455072519886094
Stenius, K., & Storbjörk, J. (2021). When the organization is a problem: An empirical study of social work with substance use problems in more or less NPM-influenced Swedish municipalities. Nordic Social Work Research.
http://dx.doi.org/10.1080/2156857X.2021.1907613
Storbjörk, J. (2020). How substance use treatment professionals manage organisational tensions: a web survey and an interview study. SUCHT 66(2), 93-103, https://doi.org/10.1024/0939-5911/a000647
Stenius, K., & Storbjörk, J. (2020). De nordiska länderna har helt olika upphandlingsregler för missbruksvård, Popnad, 11 februari 2020,
https://nordicwelfare.org/popnad/artiklar/de-nordiska-landerna-har-helt-olika-upphandlingsregler-for-missbruksvard/
Storbjörk, J., Antonsson, E., & Stenius, K. (2019). The Swedish addiction treatment system: Government, steering and organization. Technical report. Research Reports in Public Health Sciences (RRPHS) 2019:1. Stockholm: Stockholm University.
https://doi.org/10.17045/sthlmuni.9906542.v1
Storbjörk, J., & Stenius, K. (2019). Why Research Should Pay Attention to Effects of Marketization of Addiction Treatment Systems. Journal of Studies on Alcohol and Drugs. Epub ahead of print. https://doi.org/10.15288/jsads.2019.s18.31
Storbjörk, J., & Stenius, K. (2018). The new privatized market : A question of ideology or pragmatism within the Swedish addiction treatment system? Social Policy & Administration. Epub ahead of print. https://doi.org/10.1111/spol.12414
Storbjörk, Jessica & Samuelsson, Eva (2018). Brukarinflytande på vårdmarknaden – en paradox i missbruks- och beroendevården? [User involvement on the care market – a paradox in addiction treatment?]. I Marie Sallnäs & Stefan Wiklund (red.), Socialtjänstmarknaden – om marknadsorientering och konkurrensutsättning inom individ- och familjeomsorgen [The social services market – on marketization and competition], pp. 85-115. Stockholm: Liber.
Stenius, K (2017). God vård kräver kontrollerad konkurrens, men inte bolagisering [Good care requires controlled competition, not incorporation]. Hufvudstadsbladet, 28 feb-17. (https://www.hbl.fi/artikel/god-vard-kraver-kontrollerad-konkurrens-men-inte-bolagisering/ last accessed 4 January 2018).